EP0973462A1 - Extenseur chirurgical ayant un contour profile - Google Patents

Extenseur chirurgical ayant un contour profile

Info

Publication number
EP0973462A1
EP0973462A1 EP98915475A EP98915475A EP0973462A1 EP 0973462 A1 EP0973462 A1 EP 0973462A1 EP 98915475 A EP98915475 A EP 98915475A EP 98915475 A EP98915475 A EP 98915475A EP 0973462 A1 EP0973462 A1 EP 0973462A1
Authority
EP
European Patent Office
Prior art keywords
stent
leading
curvature
trailing
radius
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP98915475A
Other languages
German (de)
English (en)
Other versions
EP0973462B1 (fr
Inventor
John J. Frantzen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cook Inc
Original Assignee
Frantzen John J
Cook Inc
Global Therapeutics Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Frantzen John J, Cook Inc, Global Therapeutics Inc filed Critical Frantzen John J
Publication of EP0973462A1 publication Critical patent/EP0973462A1/fr
Application granted granted Critical
Publication of EP0973462B1 publication Critical patent/EP0973462B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958—Inflatable balloons for placing stents or stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/04—Metals or alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/068—Modifying the blood flow model, e.g. by diffuser or deflector
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30182—Other shapes
    • A61F2002/30187—D-shaped or half-disc-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
    • A61F2002/91541—Adjacent bands are arranged out of phase
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91566—Adjacent bands being connected to each other connected trough to trough
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0034—D-shaped

Definitions

  • the following invention relates to surgical stents of a generally tubular configuration which can be surgically implanted into a body lumen, such as an artery, and be radially expanded to support the lumen. More specifically, this invention relates to radially expandable surgical stents which exhibit an inner surface which has a streamlined contour and a finely polished surface to minimize disruption of bodily fluid flow through the lumen.
  • Surgical stents have long been known which can be surgically implanted into a body lumen, such as an artery, to reinforce, support, repair or otherwise enhance the performance of the lumen.
  • a body lumen such as an artery
  • the stent once in place, reinforces that portion of the artery allowing normal blood flow to occur through the artery.
  • One form of stent which is particularly desirable for implantation in arteries and other body lumens is a tubular stent which is formed as a complete tubular cylinder and can be radially expanded from a first smaller diameter to a second larger diameter.
  • Such radially expandable stents can be inserted into the artery by being located on a catheter and fed internally through the arterial pathways of the patient until the unexpanded stent is located where desired.
  • the catheter is fitted with a balloon or other expansion mechanism which exerts a radial pressure outward on the stent causing the stent to expand radially to a larger diameter.
  • Such expandable stents exhibit sufficient rigidity after being expanded that they will remain expanded after the catheter has been removed.
  • Radially expandable stents come in a variety of different configurations to provide optimal performance to various different particular circumstances.
  • the patents to Lau Patent Nos. 5,514,154, 5,421,955, and 5,242,399), Baracci (Patent No. 5,531,741), Gaterud (Patent No. 5,522,882), Gianturco (Patent Nos. 5,507,771 and 5,314,444), Termin (Patent No. 5,496,277), Lane (Patent No. 5,494,029), Maeda (Patent No. 5,507,767), Marin (Patent No. 5,443,477), Khosravi (Patent No. 5,441,515), lessen (Patent No.
  • thrombus a phenomenon where a fibrous clot forms within cracks and other irregularities in the surface finish of an implanted object (such as a stent) is enhanced when the surfaces of the stent are not finely polished.
  • the inner surface of the stent is substantially planar and has abrupt edges along borders thereof, turbulence is introduced into the blood.
  • plaque and other deposits are provided with a site for collection and potential narrowing of the arteries and restriction of blood flow this plaque buildup adjacent an implanted object (such as a stent) is referred to as "restenosis.”
  • the radially expandable surgical stent of this invention exhibits an overall tubular cylindrical hollow seamless contour which can feature any of a variety of different arrangements for individual elements and segments forming the stent.
  • the various different segments of the stent have a generally elongate, substantially constant cross-sectional contour which can either be oriented to extend axially, circumferentially, or some combination thereof, with each segment located between an inner diameter of the stent and an outer diameter of the stent.
  • Each segment includes an outer surface coextensive with the outer diameter of the stent and an inner surface coextensive with the inner diameter of the stent.
  • Each segment also includes lateral surfaces extending between the inner surface and the outer surface which can either be a leading surface on an upstream side of the segment, a trailing surface on a downstream side of the segment, or a lateral surface generally aligned axially with the stent.
  • each segment of the stent is extensively streamlined to minimize disruption of bodily fluid flow through the body lumen.
  • the inner surface includes an inner leading edge and an inner trailing edge bordering the inner surface.
  • Each inner edge is defined by an inner curve having a relatively large radius of curvature when compared to the radii of curvature exhibited by outer edges adjacent the outer surface of each stent segment. Because the inner edges have a large radius of curvature, they do not present any abrupt transition in flow for bodily fluids passing over the inner surface of the stent segment, particularly when the stent segment is aligned circumferentially with bodily fluid flow passing adjacent the inner surface from a leading inner edge to a trailing inner edge.
  • each stent segment are configured to have a surface finish which is free from abrupt transitions and irregularities, such as prominences extending more than five micro inches above adjacent portions of the surrounding surface. Smooth flow of blood or other bodily fluids over the surfaces of the stent can thus be preserved and a risk of medical complications such as restenosis and thrombus can be minimized.
  • Figure 1 is a perspective view of a radially expandable surgical stent featuring the streamlined contour of this invention.
  • Figure 2 is a cylindrical projection of an alternative stent of that which is shown in Figure 1 which also features the streamlined contour of this invention.
  • Figure 3 is a perspective view of a stent segment representative of stent segments of another alternative stent to that which is shown in Figure 1.
  • Figure 4 is a perspective view of a stent segment similar to that which is shown in Figure 3, but exhibiting a contour found in many representative prior art stents.
  • Figure 5 is a full sectional view taken along line 5-5 of Figure 1 , 2 or 3 revealing a specific contour of surfaces of the stent segments according to this invention.
  • Figure 6 is a full sectional view taken along line 6-6 of Figure 4 revealing details of a typical contour of a representative prior art stent segment.
  • Figure 7 is a full sectional view similar to that which is shown in Figure 5 and further revealing details of the contour of segments forming a stent according to this invention.
  • Figure 8 is a full sectional view of a stent featuring the preferred cross-sectional contour of this invention and shown implanted within a lumen, such as an artery.
  • Figure 9 is a full sectional view of a lumen, such as an artery, with a prior art stent implanted therein.
  • reference numeral 10 is directed to a radially expandable surgical stent (Figure 1) for implantation within a body lumen L ( Figure 8) and to which the specific contour of this invention can be applied.
  • a stent such as the surgical stent 10 is formed from multiple stent segments, such as the stent segments 40 ( Figure 3) which feature a particular cross-sectional contour ( Figure 5).
  • This contour is characterized by having an inner surface 44 which is dissimilar to an outer surface 42 such that the inner surface 44 is streamlined to minimize disruption of bodily fluid flow passing over the inner surface 44 when the stent 10 is implanted within a body lumen L ( Figure 8).
  • each stent segment 40 is an elongate construct of substantially constant cross-sectional generally rectangular form, having an outer surface 42 opposite an inner surface 44. Two lateral side surfaces including a leading surface 46 and a trailing surface 48 extend between the inner surface 44 and the outer surface 42.
  • the inner surface 44 is provided with an inner leading edge 54 and an inner trailing edge 56 which are defined by an inner leading curve 60 and an inner trailing curve 62, respectively, with sufficiently high radii of curvature 70, 72 ( Figure 7) that the inner surface 44 is highly streamlined between the inner leading edge 54 and the inner trailing edge 56.
  • the outer surface 42 extends between two side edges including an outer leading edge 50 and an outer trailing edge 52.
  • the outer leading edge 50 is defined by an outer leading curve 64 and the outer trailing edge 52 is defined by an inner trailing curve 62.
  • the inner leading curve 60 and inner trailing curve 62 are have radii of curvature 74, 76 ( Figure 7) which are less than the radii of curvature 70, 72 of the inner leading curve 60 and the inner trailing curve 62 ( Figure 5).
  • the stent segment 40 thus has a contour which presents a highly streamlined gradually curving surface for passage of bodily fluid B (Figure 8) there over and the outer surface 42 presents a more abrupt contour for secure positioning adjacent an inner surface S of the body lumen L ( Figure 8).
  • the contour featured by this invention can be beneficially incorporated into surgical stents of a variety of different configurations, and stents of a variety of different materials, including radially expandable metallic stents formed of surgical steel, nickel titanium, polyhydrocarbons, metallic alloys or other implantable materials.
  • the radially expandable surgical stent 10 ( Figure 1) can exhibit streamlined segments having the contour of the stent segment 40 shown in Figure 5, as represented by section lines 5-5.
  • the surgical stent 10 is formed from a series of separate circumferential elements 12 passing circumferentially, along arrow C, entirely around the cylindrical radially expandable surgical stent 10, preferably in a seamless manner.
  • Axial elements 14, extending along arrow A, are affixed between adjacent circumferential elements 12 to tie the circumferential elements 12 together and form the stent 10 as a single tubular unit.
  • the inner surface 44 faces radially inward toward a central axis of the stent 10 and the outer surface 42 faces radially outward (along arrow R) away from a central axis of the stent 10.
  • the surgical stent 10 can beneficially support a body lumen L (Figure 8) with individual stent segments 40 having a minimal effect on blood/fluid flow B through a body lumen L, such as an artery.
  • a body lumen L Figure 8
  • an alternative stent 20 is shown ( Figure 2) exhibiting the unique contour of this invention.
  • a series of serpentine circumferential elements 22 are oriented circumferentially surrounding the alternative stent 20, along arrow C.
  • Axial elements 24 are oriented axially, aligned with arrow A, and tie adjacent circumferential elements 22 together. Angled elements 26 replace axial elements 24 between some pairs of circumferential elements 22 to provide additional flexibility to the alternative stent 20, as shown by section line 5-5 of Figure 2.
  • the streamlined contour of the stent segment 40 of Figure 5 can be incorporated into the alternative stent 20 to provide the benefits of the contour of the stent segment 40 to the alternative stent 20 in a manner similar to that described above with respect to the surgical stent 10 of Figure 1.
  • FIG. 3 Another alternative stent 30 (Figure 3) is designed with stent segments 40 including circumferential elements 32 extending in a serpentine pattern circumferentially, along arrow C around the stent 30 with axial elements 34 joining adjacent circumferential elements 32.
  • the axial element 34 joins to the circumferential element 32 adjacent a crest 36 in the circumferential element 32.
  • such stents, represented by reference numeral 30' are common in the prior art which feature stent segments 40' but which lack the particular contour of the stent segment 40 of this invention.
  • the circumferential elements 32 of the alternative stent 30 and the axial elements 34 of the alternative stent 30 can similarly be provided with the unique contour exhibited in Figure 5, as represented by section line 5-5 shown in Figure 3.
  • the stent segment 40 is oriented axially along arrow A, blood/body fluid flow B over the inner surface 44 of the stent segment 40 is rotated 90° when compared to the orientation of the stent segment 40 and inner surface 44 when the circumferential element 32 in which the inner surface 44 is located extends circumferentially, as shown in Figures 1 and 2 by section lines 5-5.
  • FIGs 5 and 7 details of the particular contour of the stent segment 40 are described.
  • the stent segment 40 is an elongate substantially rigid construct having a substantially constant cross-section as represented in Figure 5. This cross-section exhibits a contour which is streamlined to optimize blood/body fluid flow B ( Figure 8) over the inner surface 44 of the stent segment 40.
  • the stent segment 40 is somewhat rectangular in cross-section except that corners of the cross-section of the stent segment 40 are curved to varying degrees, altering the cross-sectional contour of the stent segment 40 away from what would be a more particularly rectangular contour.
  • an outer surface 42 is presented forming one surface of the stent segment 40, substantially coextensive with an outer diameter of the surgical stent 10, or alternative stents 20, 30.
  • An inner surface 44 is oriented opposite the outer surface 42.
  • the inner surface 42 is coextensive with an inner diameter of the stents 10, 20, 30 and is roughly parallel to the outer surface 42. Because the inner surface 44 is highly rounded the inner surface 44 is actually only parallel to the outer surface 42 adjacent a middle region of the inner surface 44.
  • Two lateral side surfaces 46, 48 extend between the inner surface 44 and the outer surface 42 and form the remaining two sides of the somewhat rectangular stent segment 40.
  • the lateral side surfaces 46, 48 include a leading surface 46 and a trailing surface 48.
  • leading surface 46 is oriented facing upstream much of the time when a stent such as the surgical stent 10, fitted with the stent segment 40 of this invention is implanted within a body lumen L ( Figure 8), it is also possible that the leading surface 46 can in fact be oriented parallel to a direction of flow of blood/fluid flow B within a body lumen L if the stent segment 40 is oriented axially, such as is shown in Figure 3 for the alternative stent 30.
  • the trailing surface 48 while often facing downstream when incorporated into a stent 10 implanted within a body lumen L, can have other orientations when incorporated into stents of different configurations.
  • the terminology “leading” and “trailing” is not intended to limit the orientation in which these lateral side surfaces 46, 48 can be oriented.
  • the outer surface 42 extends between an outer leading edge 50 and an outer trailing edge 52.
  • the outer leading edge 50 defines a transition between the outer surface 42 and the leading surface 46.
  • the outer trailing edge 52 defines a transition between the outer surface 42 and the trailing surface 48.
  • the outer surface 42 is preferably substantially planar between the outer leading edge 50 and the outer trailing edge 52.
  • the inner surface 44 extends between an inner leading edge 54 and an inner trailing edge 56.
  • the inner surface 44 preferably has a small substantially planar area at a mid point between the inner leading edge 54 and the inner trailing edge 56 which is substantially parallel to the outer surface 42.
  • a thickness T of the stent segment 40 is defined by the distance between the outer surface 42 and the inner surface 44.
  • the inner surface 44 can lack any planar region but rather curve continuously between the inner leading edge 54 and the inner trailing edge 56 with the thickness T of the stent segment 40 defined by a distance between the outer surface 42 and a mid point in the inner surface 44 between the inner leading edge 54 and the inner trailing edge 56, where the thickness T of the stent segment 40 is at a maximum.
  • the leading surface 46 and trailing surface 48 are preferably mirror images of each other and extend between the inner surface 44 and outer surface 42, smoothly joining the inner surface 44 with the outer surface 42 without any abrupt transitions between the outer surface 42 and the inner surface 44.
  • the leading surface 46 and trailing surface 48 preferably do not have any planar regions thereon, but rather continuously curve between the inner surface 44 and the outer surface 42.
  • the stent segment 40 thus has each surface 42, 44, 46, 48 joining to adjacent surfaces through edges 50, 52, 54, 56, somewhat analogous to the four corners of a rectangle.
  • the inner leading edge 54 has a contour specifically defined by an inner leading curve 60 extending from the leading surface 46 to the inner surface 44.
  • the inner trailing edge 56 has its contour defined by an inner trailing curve 62 extending from the inner surface 44 to the trailing surface 48.
  • the inner curves 60, 62 are free of abrupt transitions, but rather provide a smooth transition between the lateral side surfaces 46, 48 and the inner surface 44.
  • the inner curves 60, 62 are exact mirror images of each other.
  • each curve 60, 62 is provided with a radius of curvature including the inner leading radius of curvature 70 and the inner trailing radius of curvature 72.
  • Each inner radius of curvature 70, 72 extends from a center of curvature such as the inner leading center of curvature 80 or the inner trailing center of curvature 82.
  • the exact radii of curvature for the inner curves 60, 62 and the centers of curvature 80, 82 for the inner curves 60, 62 can be varied somewhat to conform to the particular design parameters of the application in which the stent segment 40 is to be utilized.
  • Factors to consider in the design of the contour for the inner curves 60, 62 and the selection of the radii of curvature 70, 72 and the centers of curvature 80, 82 include the desired coefficient of drag between the stent segment 40 and the fluid passing adjacent thereto, the viscosity of the fluid intended to be passing adjacent thereto, the diameter of the stent 10 in which the stent segment 40 is located, the extent to which the stent 10 is expected to embed itself into inner surfaces S of the body lumen L in which the stent 10 is implanted ( Figure 8), and other design parameters relevant to the particular application in which the stent 10 is to be utilized.
  • radii of curvature 70, 72 it is considered preferable for many applications to form the radii of curvature 70, 72 to have a size greater than the size of the thickness T of the stent segment 40, such that the centers of curvature 80, 82 are located above the outer surface 42 of the stent segment 40.
  • a thickness T of the stent segment 40 is 0.003 inches
  • radii of curvature 70, 72 for the inner curves 60, 62 can be 0.004 inches or greater. While useful in illustrating the specific contour of the inner curves 60, 62, it is not required that the inner curves 60, 62 have constant radii of curvature 70, 72 or a constant position for the centers of curvature 80, 82.
  • the inner curves 60, 62 in fact be a "French" curve without a constant radius of curvature or an exact fixed position for a center of curvature.
  • the inner curves 60, 62 exhibit such a French curve contour, the radii of curvature 70, 72 are initially smaller adjacent the lateral side surfaces 46, 48 and the centers of curvature 80, 82 are initially closer to the inner surface 44.
  • the radii of curvature 70, 72 increase and the position of the centers of curvature 80, 82 move away from the inner surface 44.
  • the resulting contours of the inner curves 60, 62 are somewhat analogous to streamlined surfaces found effective in minimizing coefficients of drag.
  • the outer leading edge 50 and outer trailing edge 52 of the outer surface 42 are defined by an outer leading curve 64 and an outer trailing curve 66, respectively.
  • the outer curves 64, 66 are similar to each other but contrasted with the inner curves 60, 62 adjacent the inner surface 44. Specifically, the outer curves 64, 66 are defined by an outer leading radius of curvature 76 and an outer trailing radius of curvature 78 distinct from the radii of curvature 70, 72 of the inner curves 60, 62. Additionally, the outer curves 64, 66 are centered upon an outer leading center of curvature 86 and an outer trailing center of curvature 88 which are closer to the outer curves 66, 68 than is the case with the inner curves 60, 62.
  • the outer curves 64, 66 are similar in contour to each other and exhibit fixed radii of curvature 74, 76 which are less than half of a size of the thickness T of the stent segment 40. Unlike the inner curves 60, 62, the outer curves 64, 66 preferably exhibit radii of curvature 74, 76 which are constant in size and with fixed centers of curvature 84, 86. Because the outer curves 64, 66 are configured to rest against the inner surface S of the lumen
  • the outer curves 64, 66 are sufficiently abrupt to allow the outer surface 42 to securely engage the inner surface S of the lumen L and resist displacement of the stent 10 longitudinally along the lumen L away from the stent' s original and desired position.
  • the lateral side surfaces 46, 48 are preferably spaced apart by a width W which is defined as the dimension of greatest distance between the leading surface 46 and the trailing surface 48 of the stent segment 40.
  • This maximum width W point also defines a transition where the contour of the outer curves 64, 66 transition to the contours of the inner curves 60, 62 for embodiments where no planar leading surface 46 or trailing surface 48 is provided.
  • the outer curves 64, 66 can gradually transition into the inner curves 60, 62 by having the radii of curvature 70, 72 of the inner curves 60, 62 match the radii of curvature 74, 76 of the outer curves 64, 66 adjacent this maximum width W point.
  • the radii of curvature 70, 72 of the inner curve 60, 62 would then begin to increase as the inner curves 60, 62 continue toward a middle of the inner surface 44.
  • the centers of curvature 80, 82 would begin to migrate from the location of the centers of curvature 84, 86 of the outer curves 64, 66 to their positions above the outer surface 42.
  • a finish of the surfaces 42, 44, 46, 48 be particularly smooth to minimize prominences which could cause irritation for tissues forming the inner surface S of the lumen L or which could disrupt blood/fluid flow B ( Figure 8) or provide sites at which plaque P, leading to restenosis or thrombus H could occur, as shown in Figure 9.
  • prior art stent segments 40' are typically substantially rectangular in cross-section with a substantially planar outer surface 42' parallel to and spaced from a substantially planar inner surface 44'.
  • a leading surface 46' is substantially planar and parallel to and spaced from a substantially planar trailing surface 48'.
  • Edges 50', 52', 54', 56' generally correspond to edges 50, 52, 54, 56 in the stent segment 40 of this invention.
  • Such prior art stent segments 40' not only lack the particular streamlining and contouring discussed above with regard to the stent segment 40, but additionally exhibit a relatively high degree of irregularities in their surface finish, lacking a smoothness desirable for optimal performance of the stent 10.
  • many stent segments 40 get etched and pitted by corrosive materials utilized to form and polish the stents (Figure 6). While such irregularities are typically microscopic and only visible with image magnifying equipment, the surfaces are sufficiently irregular (i.e. irregularities larger than five micro inches) that they cause irritation to tissues forming the inner surfaces S of lumens L in which the stents are implanted (Figure 9).
  • the surface finish have a smoothness which eliminates prominences greater than five micro inches and preferably less than two to three micro inches.
  • a stent 10 featuring stent segments 40 of this invention is implanted into a lumen L ( Figure 8) with the stent segments 40 embedding slightly into the inner surface S of the lumen L and supporting the lumen L, blood/fluid flow B is only slightly disrupted and restenosis and plaque buildup is minimized.
  • stent segments 40 having more abrupt contours cause disruption in the blood/fluid flow B producing eddies E which further disrupt blood/fluid flow B and encourage the formation of plaque P , leading to restenosis, along the inner surface S at various locations along the inner surface S.
  • Thrombus H is also stimulated by irregularities in surface finish exhibited by stent segments 40' of prior art stents.
  • the stent 10 featuring the stent segment 40 can be reversed 180° with similar function in either orientation.
  • the inner surface 44 can be provided with a more airfoil-like asymmetrical contour which does not provide the leading surface 46 and trailing surface 48 as mirror images of each other, but rather provides the leading surface 46 with a smaller radius of curvature and the trailing surface 48 with a larger radius of curvature or a tapering gradual slope, somewhat analogous to that of a tear drop in cross-section.
  • Such an asymmetrical surgical stent would necessarily only benefit from its form when implanted in a particular direction with regard to blood/fluid flow B through the lumen L.
  • This invention exhibits industrial applicability in that it provides a radially expandable surgical stent which has a generally cylindrical contour with an inner diameter defined by inner surfaces of segments forming the stent and an outer diameter defined by outer surfaces of the segments forming the stent, the inner surfaces having a streamlined contour to minimize disruption of blood flow passing over segments of the stent when the stent is implanted within an artery or other body lumen.
  • Another object of the present invention is to provide a surgical stent which minimizes medical complications such as restenosis and thrombus adjacent the stent.
  • Another object of the present invention is to provide a radially expandable surgical stent which has a finish smoothness which minimizes medical complications such as restenosis and thrombus adjacent the stent when the stent is implanted within an artery or other body lumen.
  • Another object of the present invention is to provide a surgical stent which can support a body lumen while minimizing disruption of flow of bodily fluids through the lumen.
  • Another object of the present invention is to provide a surgical stent which is reversible and can be implanted in two distinct orientations rotated 180° from each other without altering performance of the surgical stent.
  • Another object of the present invention is to provide a surgical stent which features an inner surface which has edges with greater radii of curvature than radii of curvature of outer edges bordering an outer surface of segments of the stent, such that disruption to blood flow within a body lumen in which the stent is implanted is minimized and the outer surface of the stent is securely held adjacent a wall of the lumen.

Abstract

Cette invention se rapporte à un extenseur chirurgical (10), formé de plusieurs segments d'extenseur (40) ayant un contour profilé. Chaque segment d'extenseur (40) comporte une surface externe (42) distante d'une surface interne (44). La surface interne (44) est flanquée de bords internes (54, 56) et la surface externe (42) est flanquée de bords externes (50, 52). Les bords externes (50, 52) présentent un contour défini par des courbes externes (64, 66) et les bords internes (54, 56) présentent un contour défini par des courbes internes (60, 62). Les rayons de courbure des courbes internes (70, 72) sont supérieurs aux rayons de courbure des courbes externes (64, 66). La surface interne (44) se trouve ainsi profilée pour permettre le passage du sang ou du fluide corporel (B) à proximité adjacente de la surface interne (44) et la surface externe (42) est configurée de façon particulière pour produire une adhérence maximum sans irritation d'une surface interne (S) d'un passage corporel (L), tel qu'une artère. Les surfaces (42, 44) du segment d'extenseur (40) sont dotées d'un fini de surface suffisamment lisse pour accroître davantage l'écoulement de sang ou de fluide (B) à proximité adjacente du segment d'extenseur (40) et pour réduire au minimum l'irritation des tissus formant la surface interne (S) du passage corporel (L) dans lequel est implanté l'extenseur chirurgical (10).
EP98915475A 1997-04-10 1998-04-07 Extenseur chirurgical ayant un contour profile Expired - Lifetime EP0973462B1 (fr)

Applications Claiming Priority (3)

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US839434 1986-03-13
US08/839,434 US5718713A (en) 1997-04-10 1997-04-10 Surgical stent having a streamlined contour
PCT/US1998/007249 WO1998044872A1 (fr) 1997-04-10 1998-04-07 Extenseur chirurgical ayant un contour profile

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EP0973462A1 true EP0973462A1 (fr) 2000-01-26
EP0973462B1 EP0973462B1 (fr) 2006-06-14

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EP (1) EP0973462B1 (fr)
JP (1) JP4481371B2 (fr)
KR (1) KR20010006261A (fr)
AT (1) ATE329549T1 (fr)
AU (1) AU750277B2 (fr)
CA (1) CA2286665C (fr)
DE (1) DE69834909T2 (fr)
WO (1) WO1998044872A1 (fr)

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8197881B2 (en) 2003-09-22 2012-06-12 Conor Medsystems, Inc. Method and apparatus for loading a beneficial agent into an expandable medical device
US8133277B2 (en) 2004-10-21 2012-03-13 Bard Peripheral Vascular, Inc. Medical device for fluid flow and method of forming such device
US8011316B2 (en) 2006-10-18 2011-09-06 Innovational Holdings, Llc Systems and methods for producing a medical device
EP3431049A4 (fr) * 2016-03-16 2019-10-02 Terumo Kabushiki Kaisha Stent

Also Published As

Publication number Publication date
ATE329549T1 (de) 2006-07-15
AU750277B2 (en) 2002-07-11
CA2286665A1 (fr) 1998-10-15
DE69834909T2 (de) 2007-01-04
KR20010006261A (ko) 2001-01-26
US5718713A (en) 1998-02-17
JP4481371B2 (ja) 2010-06-16
WO1998044872A1 (fr) 1998-10-15
CA2286665C (fr) 2008-01-29
JP2002501409A (ja) 2002-01-15
EP0973462B1 (fr) 2006-06-14
AU6965198A (en) 1998-10-30
DE69834909D1 (de) 2006-07-27

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